There are multiple bursae located around the hip joint. These bursae are present where friction normally occurs between the muscles, tendons, and bones. A bursa is a thin sack containing minimal fluid which lubricates the tissue to decrease friction.
There are three different types of bursae located around the hip area:
- The Greater Trochanter group of bursa
- Iliopsoas bursa
- Ischial bursa
Three main bursae surround the greater trochanter of the femur:
Greater Trochanter Group of Bursa
- Subgluteus medius bursa: smaller bursa between the gluteus medius muscle and the greater trochanter, just medial to the trochanteric bursa.
- Trochanteric Bursa: located just superficial to the greater trochanter and the attachments of the gluteal muscles. If the trochanteric bursa becomes irritated and inflamed, this can lead to trochanteric bursitis.
- Subgluteus Minimus Bursa: lies beneath the gluteus minimus tendon at the anterosuperior edge of the greater trochanter.
Some people believe that there are over twenty bursas around the greater trochanter of the femur. Needling of the bursa in different directions may be helpful when the physician injects steroids into the bursa. Trochanteric bursitis is often associated with iliotibial band syndrome.
The iliopsoas bursa lies between the iliopsoas muscle at the front of the hip joint and the underlying bone. The bursa may become irritated and inflamed due to friction from the iliopsoas muscle where it crosses the hip joint.
The Ischial bursa is also called “weaver’s bottom” or “tailor’s seat”. This bursa prevents friction between the gluteus maximus and the ischial tuberosity. The bursa is located on the posterior side of the ischium. Bursitis of the ischial bursa may be caused by prolonged sitting on a hard surface, which aggravates the bursa. The patient will complain of tenderness and pain in the buttock area during sitting.